title: V1-V2-V3-V4 T wave inversion: left or right ventricle?
abstract: An 84-year-old woman, affected by Alzheimer's disease, presented to the emergency department with intense dyspnoea. Since ECG was showing T wave inversion in anterior leads and troponin-T was high, the patient was admitted to our unit with a diagnosis of anterior non-ST elevation myocardial infarction. However, the patient's medical history and a further review of the ECG led us to suspect a pulmonary embolism (PE) as a possible differential clinical diagnosis. We tested this alternative hypothesis: echocardiography as well as contrast-enhanced CT scan confirmed the diagnosis of PE. We describe these misleading ECG findings together with a brief discussion of electrocardiographical changes in pulmonary embolism.
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mirijello
authors.forename: Roberto
authors.initials: R
authors.lastname: Pola
authors.forename: Luisa
authors.initials: L
authors.lastname: Saviano
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed